Maureen O'Sullivan (Dublin Central, Independent) | Oireachtas source

We are all making our way through the seven ages of man as described by Shakespeare. It is fair to say that each age from childhood on brings its own joys but also frustrations and challenges so that by the time we reach that older age we have experienced a great deal. The majority of older people have worked all through their lives. They have paid their taxes and reared their children and many are now rearing grandchildren also. Many of them are the carers for family members with disabilities. I acknowledge the great voluntary work that so many older people have done throughout their lives.

I do not think there is a village, town or community in Ireland, urban or rural, that has not benefited from the huge array of voluntary work done by older people in the course of their lives. The expectation is that when they get to that older age, life should get easier, not much more difficult.

It is very good that, tonight and tomorrow, thanks to Deputy Fleming's motion, we have an opportunity to talk about and highlight life for older citizens. To use the cliché, they are the unsung heroes of Irish life. However, there are glaring examples of where they are not treated appropriately. It is very sad to see senior citizens living in situations that do not afford them dignity, as I have seen in my own constituency in Dublin Central and I am sure it is the same in other constituencies. The loss of the Christmas bonus some years ago was a devastating blow, especially to those living in poorer circumstances.

Sustaining independent living is very important, and part of that is keeping people out of nursing homes when there is no need for them to be there. This comes back to home care. In the community in which I live, East Wall, excellent home help care is available, mainly provided by local women. There is a great relationship between the carer and the person for whom they are caring. In so many cases, they are giving far more than the hours for which they are being paid. There is also very good community care in East Wall, with social events and outings organised by the community for seniors, and facilities and events in the day care centre. We also have very positive intergenerational exchanges with the local school and youth club.

However, there are deficiencies in the home care area. There is no regulation of home care contracts. What we are seeing is a lot of privatisation, with agencies springing up. The agencies are good at the tendering aspect of presenting low cost care, but low cost care means lower paid care workers with poor conditions of employment. This is very particular to rural areas, where one carer may have to travel long distances from one client to another, with no travel expenses. All of that is impacting on the quality of care provided. Quality standards have to be in place to deliver quality care. Our seniors who need home care and home help deserve no less than those high standards. Therefore, one request is for home care services to be regulated. I am thinking in particular of three ladies I know who are well into their 80s and who, because they have support from home help and their families, are able to live in their communities in their own homes.

I thank Age Action for the information in regard to the budget for this area. It notes that 72% of the budget is spent on nursing home support schemes, 14% on home help and 9% on home care packages. With a decline in funding for home help services and a decline in the number of home help hours, we know more people are being admitted to nursing homes who could stay in their homes. This is not an efficient use of resources, so something is wrong. I thank ALONE for providing the information that the proportion of older people in nursing homes in Ireland is 35% higher than in other EU countries and the second highest in Europe. This brings me to my point on the need for a statutory entitlement to more care, in the same way an older person needing long-term care has a right to State financial support.

Deputy Fleming mentioned "reablement". A pilot project carried out in north Dublin by the HSE had very positive results after the six-week programme in that people were able to stay in their homes and needed less home help support and fewer hours. What is needed is a serious look at the continuum of care so that needs are met as they arrive and also at how funding is allocated. ALONE tells us that one in three of those in nursing home beds could live in their communities. Its "Home First" campaign shows that one third of older people in long-stay beds have low to medium support needs. In addition, if the housing adaptation grant could be accessed more promptly, this could mean people staying in their homes.

I mentioned my own community. The Minister of State will know it from his time teaching there that there are great facilities for older people in the Docklands area. However, I believe that loneliness is a major problem, sometimes in the cities but more particularly in isolated rural areas where there could be miles between one person and their nearest neighbour. The two venues that used to provide contact, support, friendliness and the personal touch - the pub and the post office - are under serious threat, with a number of closures, and we can add to that the closing of the rural Garda stations. All of this is contributing to feelings of insecurity, loneliness and isolation. While I am not advocating drink-driving, I doubt it was our senior citizens who were responsible for traffic and road fatalities. Nonetheless, when one social venue is removed, it needs to be replaced with another.

Older people, either couples or individuals, may reach a point in their lives when their three-bedroom or four-bedroom home is more than they need. We should have a system where they can get out of that home and transfer into supported living. I receive frequent calls from elderly people living alone who have nobody to help them. Age Action is great at doing various jobs but there are some jobs that it cannot do without further support. To have senior citizens, in particular those with disabilities and those in various stages of dementia, coming into hospital accident and emergency departments is appalling. There is a need for designated intellectual disability nurses if we do not want senior people presenting at primary health care centres.

We know the consternation that arose when free travel appeared to be under threat recently. Free travel is a contributing factor in the independence of the elderly and, for many, it is their sole means of getting around and getting to essential services and appointments. It is also a gateway to social life and visiting places and people. Of course, when older people avail of free travel, they spend money. There is discrimination against older people when it comes to car insurance. Older people, even those who have had no claims on their insurance policies all of their lives and are in very good health, can still find it next to impossible to get car insurance.

I hosted an Irish Food Writers Guild event on the health of the nation in the AV room in Leinster House today. One of the points made by the speakers concerned the relationship between food and health. Diet and nutrition are major killers in the developed world and, therefore, better eating is intrinsically linked to better health and well-being, with significant economic gains. The speakers called for the Government to revise food and health spending because better eating means improved lifelong health. They gave an example from Copenhagen of an older person's home for people with disabilities where a change in the diet, the food and the cooking meant fewer visits to doctors and hospitals, which meant savings. With increasing numbers of older people living longer, it is a challenge for the Government and succeeding governments. However, it points to the need to plan ahead. Yeats said this is no country for old men, but Ireland should be a country for old men and for old women because, at that stage - we will all get there, hopefully - we will need those supports.

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